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Grievance and Appeal Specialist

Company: VirtualVocations
Location: Eugene
Posted on: April 1, 2025

Job Description:

A company is looking for a Grievance & Appeal Specialist.
Key Responsibilities

Conduct and document thorough investigations of grievances, complaints, and appeals
Ensure accurate documentation of cases in the appeals management system and maintain compliance with reporting requirements
Communicate resolutions to members, providers, and clients effectively

Required Qualifications

High school diploma/GED required; Bachelor's degree in a related field preferred
Two plus years of appeals and grievance experience or related experience required
Broad knowledge of plan products, processes, and enrollment rules
Ability to perform research and evaluate documentation requirements
Familiarity with compliance reporting and data validation requirements

Keywords: VirtualVocations, Eugene , Grievance and Appeal Specialist, Other , Eugene, Oregon

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